Strategies for Trial Design and Analyses
This chapter reviews various methodological issues related to trial design and analysis in the current context of research in leukemia. After reviewing the basics of experimental designs (Sect. 5.1), we discuss some issues in planning clinical research th
- PDF / 4,523,644 Bytes
- 349 Pages / 439.37 x 666.142 pts Page_size
- 93 Downloads / 187 Views
Vaskar Saha Pamela Kearns ●
Editors
New Agents for the Treatment of Acute Lymphoblastic Leukemia
Editors Vaskar Saha Paediatric and Adolescent Oncology School of Cancer and Enabling Sciences Manchester Academic Health Science Centre The University of Manchester Manchester M20 4BX [email protected]
Pamela Kearns School of Cancer Sciences University of Birmingham Edgbaston, Birmingham B15 2TT [email protected]
ISBN 978-1-4419-8458-6 e-ISBN 978-1-4419-8459-3 DOI 10.1007/978-1-4419-8459-3 Springer New York Dordrecht Heidelberg London Library of Congress Control Number: 2011925850 © Springer Science+Business Media, LLC 2011 All rights reserved. This work may not be translated or copied in whole or in part without the written permission of the publisher (Springer Science+Business Media, LLC, 233 Spring Street, New York, NY 10013, USA), except for brief excerpts in connection with reviews or scholarly analysis. Use in connection with any form of information storage and retrieval, electronic adaptation, computer software, or by similar or dissimilar methodology now known or hereafter developed is forbidden. The use in this publication of trade names, trademarks, service marks, and similar terms, even if they are not identified as such, is not to be taken as an expression of opinion as to whether or not they are subject to proprietary rights. While the advice and information in this book are believed to be true and accurate at the date of going to press, neither the authors nor the editors nor the publisher can accept any legal responsibility for any errors or omissions that may be made. The publisher makes no warranty, express or implied, with respect to the material contained herein. Printed on acid-free paper Springer is part of Springer Science+Business Media (www.springer.com)
Brief Overview
Over 80% of children with acute lymphoblastic leukemia (ALL) are cured by modern chemotherapeutic regimens. These are the results of carefully conducted randomised clinical trials. Mainly, current protocols have progressively intensified therapy for all children and now use risk stratification to intensify treatment for high-risk subgroups. As a result, therapy-related toxicity now outweighs disease recurrence as a determinant of outcome. The prognosis for those who relapse or do not respond to therapy remains poor. Further intensification is unlikely to benefit those who fail therapy and may increase toxicity for those who do. Perhaps, the most intense of therapies is allogeneic bone marrow transplantation. However, disease recurrence is the most common cause of transplantation failure in these patients. The drugs that we use for ALL are now over 30 years old. To improve outcome further and to decrease toxicity, we need new drugs. These are exciting times. At long last, new agents that can potentially be used in the ALL armamentarium are increasing rapidly. These include both conventional cytotoxics and targeted therapy. However, there are a number of problems that need to be solved. How does one eval
Data Loading...
